Government - Hospital district · 120 certified beds · CMS number 455771
Hearthstone Nursing and Rehabilitation, Round Rock, TX
CMS records 24 health deficiencies at Hearthstone Nursing and Rehabilitation in Round Rock, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Apr 3, 2026. The highest severity cited is K (immediate jeopardy to resident health or safety). 3 citations were at the immediate jeopardy level, 3 of them recorded as past non-compliance (fixed before the inspection). CMS lists 2 fines totaling $25,626 in the last three years.
- 24deficiencies, 3 cycles (TX median 25)
- 7in the latest cycle (TX median 8)
- Khighest severity · Immediate jeopardy
- $25,626fines, last 3 years
- 3CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Hearthstone Nursing and Rehabilitation as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Hearthstone Nursing and Rehabilitation may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (7 deficiencies)
Standard inspection Apr 3, 2026. CMS counts 7 health deficiencies and 0 fire safety deficiencies in this cycle.
Apr 3, 2026 · Standard inspection
4 deficiencies, highest E
F925 · Pest control
Requirement cited (CMS): Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 17, 2026
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 17, 2026
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 17, 2026
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 17, 2026
Jan 14, 2026 · Complaint inspection
1 deficiency, highest D
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 26, 2026
Nov 19, 2025 · Complaint inspection
2 deficiencies, highest D
F646 · Reporting changes for PASARR residents
Requirement cited (CMS): Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Nov 26, 2025
F644 · Coordinating with PASARR screening
Requirement cited (CMS): Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Nov 26, 2025
Previous cycle: 4 deficiencies (standard inspection Jan 30, 2025)
Standard inspection Jan 30, 2025. CMS counts 4 health deficiencies and 2 fire safety deficiencies in this cycle.
Jan 30, 2025 · Standard inspection
2 deficiencies, highest D
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 17, 2025
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 17, 2025
Dec 19, 2024 · Complaint inspection
2 deficiencies, highest G
F842 · Complete, confidential medical records
Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 14, 2025
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- G Actual harm (not immediate jeopardy), isolated
- Status
- Past non-compliance (fixed before the inspection), Dec 3, 2024
Earlier cycle: 13 deficiencies (standard inspection Dec 14, 2023)
Standard inspection Dec 14, 2023. CMS counts 13 health deficiencies and 1 fire safety deficiency in this cycle.
Apr 3, 2024 · Complaint inspection
1 deficiency, highest D
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 25, 2024
Feb 13, 2024 · Complaint inspection
3 deficiencies, highest E
F758 · Psychotropic drug safeguards
Requirement cited (CMS): Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 11, 2024
- Found in
- infection control inspection
F553 · Taking part in care planning
Requirement cited (CMS): Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 11, 2024
- Found in
- infection control inspection
F552 · Being informed about health and treatment
Requirement cited (CMS): Ensure that residents are fully informed and understand their health status, care and treatments.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 11, 2024
- Found in
- infection control inspection
Dec 14, 2023 · Standard inspection
5 deficiencies, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2024
F804 · Palatable, attractive food at safe temperatures
Requirement cited (CMS): Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2024
F803 · Menus that meet nutritional needs
Requirement cited (CMS): Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2024
F692 · Nutrition and hydration
Requirement cited (CMS): Provide enough food/fluids to maintain a resident's health.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2024
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2024
Dec 2, 2023 · Complaint inspection
4 deficiencies, highest K
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Dec 8, 2023
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Past non-compliance (fixed before the inspection), Nov 16, 2023
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Past non-compliance (fixed before the inspection), Nov 16, 2023
F580 · Telling residents and families about changes
Requirement cited (CMS): Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Past non-compliance (fixed before the inspection), Nov 16, 2023
Tags cited in more than one inspection
3 tags cited on more than one inspection date at Hearthstone Nursing and Rehabilitation; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F880 Infection prevention and control program | 3 | Apr 3, 2026; Jan 30, 2025; Dec 14, 2023 |
| F600 Freedom from abuse and neglect | 2 | Dec 19, 2024 (PNC); Dec 2, 2023 (PNC) |
| F755 Pharmacy services and a consultant pharmacist | 2 | Apr 3, 2024; Dec 2, 2023 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Dec 19, 2024 | Fine | $10,033 |
| Dec 2, 2023 | Fine | $15,593 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 2.92 h (below the Texas median of 3.27 h)
- RN hours per resident per day
- 0.38 h (about the same as the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 2.53 h
- Nursing staff turnover
- 53.3% (Texas median 52.1%)
- Administrators who left
- 2
- CMS overall rating
- 3 of 5
- Health inspection rating
- 3 of 5
- Staffing rating
- 2 of 5
- Quality measure rating
- 4 of 5
CMS figures for Hearthstone Nursing and Rehabilitation, copied as published; Texas medians are ours.
Facility details
- Address
- 401 Oakwood Blvd, Round Rock, TX 78681
- Phone
- (512) 388-7494
- County
- Williamson
- Accepts
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Chain (CMS)
- Caraday Healthcare
- Certified beds
- 120
- Average residents per day
- 93.8
- In Medicare/Medicaid since
- Sep 26, 1988
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Both
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- How do staff track and report infections among residents? (F880, cited 3 times)
- How does the home screen, train, and supervise staff to protect residents? (F600, cited 2 times)
- How are new medication orders filled, and how quickly can urgent medications arrive? (F755, cited 2 times)
- How do doctors and nurses explain changes in treatment to residents and their families? (F552, cited 1 time)
Other nursing homes in Round Rock and the same chain
- Park Valley Inn Health Center
Round Rock · 42 deficiencies - San Gabriel Rehabilitation and Care Center
Round Rock · 31 deficiencies - Trinity Care Center
Round Rock · 26 deficiencies - Bel Air at Teravista
Round Rock · 22 deficiencies - Wurzbach Nursing and Rehabilitation
San Antonio · 58 deficiencies - Windcrest Nursing and Rehabilitation
Windcrest · 38 deficiencies - Sagebrook Nursing and Rehabilitation
Cedar Park · 30 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.